We Need to Talk About CAPS: A Critical Look at Vital Campus Resource

This piece is part of an ongoing series about mental well-being at Haverford. Past articles can be found here.

Two weeks ago, The Clerk released the results of the Counseling and Psychological Services (CAPS) survey, which yielded fairly positive results. By and large, it seems that CAPS serves the majority of students well, but a look at more specific comments and experiences shows that the CAPS program is severely lacking in some areas, leading to unsatisfying results for some.

An overarching theme brought up by interviewees and survey respondents was a lack of diversity. “It’s diversity in multiple ways,” said Chelsea Richardson ‘18. First there are issues with staff diversity in regards to their knowledge of queer, and gender related issues. The CAPS staff is also lacking in racial diversity and the ability to speak to issues relating to varying cultural backgrounds. Finally, the talk therapy that CAPS generally espouses is not catering to the needs of many students at Haverford, requiring them to pay a costly price to get therapy elsewhere.

In response to the survey question, “do you feel your identity has affected your comfortableness with CAPS?” many answered that it did.

In her survey response Richardson stated, “I’m already comfortable and settled in my sexual orientation and my gender identity; however, I don’t always feel comfortable talking about my queerness with CAPS counselors. They aren’t up to date on any of the vocab or current issues.”

Sophia Abraham-Raveson ‘18 expressed a similar sentiment regarding the staff’s knowledge of trans issues.“I said the acronym LGBT, but my counselor said that I left out the T,” said Abraham-Raveson. “I said I didn’t, but he insisted that I left out the T, and he said maybe what’s really happening is you hate the transsexuals. And I said you know ‘transsexuals’ really is not a current term. That’s kind of inappropriate and that’s also not true.”

Even though it was, overall, “a very negative experience” for Abraham-Raveson, this experience was specific to one counselor and there could have been others on staff at the time who were more educated on trans issues; however, Matey Scheiner ‘18 does not believe that would be enough.

“I feel like if I go to a place like this, being in the minority, and I say I need someone who specializes in trans issues, and they say, oh we have one person who’s well versed in this issue, like wow, you could only have one person? Why can’t everyone be good at it? What if I go to them, and I don’t like them? You should be able to find a therapist that you like,” expressed Scheiner.

Students from differing cultural backgrounds have also found it difficult to find counselors that they can comfortably talk to and who are knowledgeable about information relevant to their specific identity.

In their survey response, one student wrote, ”I feel like there are no culturally sensitive counselors especially with Asian American and Asian international students. There are also no counselors who look like us so of course that will affect our level of comfort.”

Another frustrated student wrote, “There is one counselor who is black and he does ALL the targeted counseling for minorities and first-generation college students. I found that one counselor about as helpful as the others – slightly more willing to listen to concerns when I shared that I am a person of color, but really unaware of what that actually means as far as my existence/experience in this school.”

There are some people of color who had good experiences with CAPS who did not have a counselor who was also a person of color. One student responded to the question, “No, not me personally, despite being a queer woman of color. I love my white female counselor.”

As evidenced above, some student-counselor relationships do end up being quite beneficial; however, there seems to be a point where CAPS counseling can stop being effective.

“CAPS is less helpful for people dealing with chronic mental illnesses, and more useful for people dealing with short-term concerns and stress.” said Richardson when speaking to the limits of CAPS.

Sarah Wingfield ‘16, who is from England, had an alarmingly negative experience with CAPS and dealing with her mental illness here at Haverford.

“The summer of my junior year, I had a complete break down” explained Wingfield. She spent time in a psychiatric ward, and after returning to Haverford she was seeing CAPS director Philip Rosenbaum three times a week for therapy sessions.

Wingfield said, “I would go and say I feel like I’m dying and I don’t know how I can get up in the morning. I was making myself sick and starving myself and I’d tell him these things and he would just say oh that’s too bad. I’m sorry you feel like that.”

Wingfield extrapolated on her situation: “At one point there was an incident involving alcohol and I had to go to the hospital.There was a Skype conversation with Philip Rosenbaum and my parents at which point he told them I was a liability to the college, and that my behavior was not conducive to the kind of behavior that they expected from students at Haverford, despite the fact that part of the reason I was partaking in those things was because I had a serious mental illness. It seems like everyone was missing the point that I had unmedicated major depression.”

Rosenbaum declined to respond to this comment due to confidentiality.

This point leads to another diversity issue among the CAPS staff: the types of therapy offered are limited. CAPS is run under an overarching philosophy emphasizing talk therapy that has been spearheaded by Rosenbaum. Essentially Rosenbaum sees sessions “as putting two good heads in a room to talk about what’s going on and we think that we’ll get to an understanding.”

In the written survey results many students expressed that they would benefit from cognitive behavioral therapy (CBT) as well, as it provides more substantial techniques for coping with certain difficulties by teaching people how to change their thought patterns.

Scheiner explained from her own experience that “for people with anxiety disorders it’s often more helpful to have some real techniques to deal with our problems, like anxious thoughts and things like that” rather than just talk therapy.

Amanda Grolig ‘19 has had an overall positive experience with CAPS, but said she too would benefit from other types of therapy. “I really like the person that I meet with. We get along really well and I feel really comfortable talking with her. The only thing that I would say is that I would definitely benefit from CBT. ”

Like many others interviewed, Grolig was definitely under the impression that CAPS does not provide CBT; however, Rosenbaum claims, “If students are interested in doing CBT they should make that need known and, if possible, we’ll match them to somebody on staff who has an interest and if not we’ll help them find somebody in the area.”

When asked if he could name a staff member who was specialized in CBT Rosenbaum stated, “At CAPS we take a generalist approach to serve the needs of as many people as possible. We have people who have experienced training in CBT. Off the top of my head it would be a bit tough to think about who that would be.”

When looking at the bigger picture one may say that CAPS is, after all, a free resource attempting to meet the needs of the many; however, when people’s needs are not met by CAPS it is not easy to go off campus to undergo therapy elsewhere. This is partly because of the cost.

Wingfield attempted to go off campus but said, “I basically had to do all of the leg work myself. I tried to find a psychologist off campus that I could talk to, but I didn’t have the funds to do that.”

Most psychologists in the area do not take insurance, partly because behavioral therapy is a tricky business for determining health insurance qualifiers, but also because Haverford is situated in a fairly wealthy area where many are able to pay the cost of a session out of pocket.

Even when one is able to find a way to pay for off campus therapy, it is not always an easy trip to get there. Scheiner said that her Friday trip off-campus takes an hour and a half one-way, forcing her to keep her Friday schedule very open.

In attempts to ensure that fewer people are having to make such strenuous trips off campus to find other mental health resources, CAPS has been taking some steps to improve its outreach in some of the “problem areas” mentioned above.

Rosenbaum spoke to some of the ways that CAPS is malleable to change. “One of the important parts of CAPS is that we’re always in the process of reflecting on our own work and seeking additional training. I think that we’re always working on better meeting the needs of our students and how to best meet those needs. For example, much of our staff had training last spring for LGBTQ issues.”

They have also partially dealt with some scheduling issues that came up in the survey by creating an online form where students can sign up for appointments. Also, the website has a feedback form for students to fill out.

Additionally, “Last year we started an advisory group on student well being,” said Rosenbaum. The group has become more active recently as well. One does not need to apply for the board on mental well-being, and anyone’s input is welcome.

One of the main stumbling points that the group has encountered though, is that “They [CAPS] really identify with one unified philosophy, which is that the relationship with the counselor is what is most important,” said Advisory Board member Stephanie Histon ’18. “There are students who do not benefit from a unified theory especially when you’re dealing with mental health, which is so varied for so many people. In that way Phillip has been really unreceptive.”

CBT has been brought up in many of the board’s meetings as something students would like to see more of in CAPS sessions. Histon said in regards to the idea that CBT may already be available, “Not everyone is comfortable asking for what they need in terms of a relationship that’s just started. People could get this from some of the specialists at CAPS but it’s just not advertised. Asking for that is hard especially if you don’t know what it is. I don’t think it’s necessarily that easy.”

Fellow Advisory Board member Emily Kingsley ’18 recounted her own experience with CAPS saying that when she asked for CBT her counselor said they had a bit of background in that area, but was not an expert in it. “It seems like if you know that’s what you want it’s possible to kind of work it out, but they don’t really present it to you as an option. It’s not a very present thing and clearly students want it to be,” said Kingsley.

Addressing one of the other CAPS diversity issues Histon commented, “There are definitely people who don’t feel like they’re represented by CAPS which is a problem especially because it’s supposed to be accessible for everyone and clearly it’s not.”

The idea that CAPS should be able to accommodate more of its students’ needs is one of the issues at the forefront of the Board’s mind; however, it’s a difficult topic that Histon says they aren’t sure how to address at the moment especially because hiring more staff doesn’t seem to be in the CAPS budget right now.

This is why the group is looking for funds and resources elsewhere to address some of the issues brought up by students and the survey. The group is attempting to create other programs, with funds partly coming from the OAR, to better meet the needs of a greater number of students.

The group is also trying so hard to make sure that the main concerns of the students are being heard and that people know more about CAPS and what it has to offer.

“The main thing that we’re trying to do this semester is to create a permanent student outreach position as part of CAPS,” explained Kingsley. “CAPS is so insular and doesn’t really know what students want and students don’t know about CAPS so we’re trying to create a permanent student volunteer position.”

The fact that CAPS exists on campus is overall beneficial for a lot of students. However, many students are having quite harmful experiences with the service. Additionally, many students are going to CAPS in time of great stress, or turbulence, and a bad therapeutic experience is not something that they should have to deal with.

CAPS outreach is not effective enough, broad enough, nor inclusive enough for much of the student body. As Scheiner puts it, “Saying we at Haverford offer free psychological services is not enough if they’re not any good for some people.”

If you would like to write a response to this piece or contribute to the series, please email The Clerk’s Editor-in-Chief Hannah Zigler at hzigler@haverford.edu or contributor Cecilia Burke at clburke@haverford.edu.

Thanks for this article. For me, CAPS is infinitely better than *not* having CAPS, because I believe practically everyone can benefit from mental healthcare–but at the same time, it falls far short of what I need as a resource. I used CAPS for my first three years at Haverford, but now I just use my parents’ insurance and get my own care off campus. Not everyone can do that, and therefore, while CAPS cannot meet every possible mental health need, they should be more responsive to student complaints. As a person with mental health issues, I often talk with other students with similar problems, and it’s disturbing how many negative opinions I hear about CAPS–far more than about other areas of the school.

Two other issues that I would like to add are:

-CAPS should consider having group therapy centered around different issues. Instead it just has information on places you can go in the city for various support groups, even though there are plenty of demographics for which Haverford could easily provide enough students to form a group facilitated by CAPS.

-the introduction that CAPS gives to first years during Customs adds to mental health stigma by implying that the typical CAPS client is just a student feeling a little stressed one week or something along those lines. In normalizing CAPS for incoming students (a very important goal) they silence the fact that a huge proportion of CAPS clients are people with way more serious or stigmatized mental health issues and make those people feel more isolated than they really are.

CAPs isn’t capable of, and shouldn’t be, providing full-service mental health services. But the college is definitely lacking in any vision or uniformity in how its therapy is administered….it’s incredibly hit or miss. I was pretty stunned that all counselors weren’t well-versed in some very common issues that students will face in college: sexual assault and eating disorders. I’ll second the call for the group-therapy approach (led by both peers and experienced clinician or specialist). So far students are taking care of that themselves (through SOAR or other student-organized groups), which fosters a great deal of trust among peers, but leaves those support networks vulnerable to whether or not anyone has time to organize them. That’s incredibly irresponsible — those support services should be the responsibility of the college.

I suffered from an eating disorder for all four years I was at Haverford, and while I would never expect them to be able to address my all my problems, I thought CAPs was inadequately equipped and functioned more like weekly check-in to make sure I wasn’t going to totally fall apart. I talked to many students who felt they were being pressured to drop out or take a year off, rather than actually have their problems addressed. I was seeing CAPs for at least a year before I realized I had an ED — although I think if someone experienced had pointed it out, I might have sought help sooner. Once I realized I had a problem, I started seeing how many other people in my social circle were struggling with the same thing, and not receiving help.

The other issue that CAPS needs to begin to address is the experience of students who are first generation college students, or the children of immigrants and refugees. Its a particular experience that, while less common, is growing in relevance as the college tries to increase its diversity profile.

The OAR was conceived with a fine idea that should be broadened to other aspects of student life: that many students struggle to ask for help. It can be extremely discouraging for students to encounter bad mental health services if it is their first time doing so, and it may deter them from seeking help in the future.